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Scientists Map Schizophrenia's Destruction

Lee Hickling
drkoop.com Health Correspondent


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  • Awestruck, researchers at UCLA saw waves of dying gray cells spread across the brains of 12 teenaged schizophrenics like forest fires raging out of control.

    "We were stunned," said lead researcher Paul Thompson, Ph.D. He and his team conducted the first study to visualize how schizophrenia develops in the brain. They hadn't expected to see such widespread devastation of brain cells happening so fast -- in less than 5 years.

    It's well known that schizophrenia is marked by abnormalities in the brain that can be seen with neural imaging, but what these abnormalities are, when they happen, and what their importance is has not been clear. Until now, no one had ever seen what the UCLA group saw in a series of pictures generated by a super-computer from data obtained by a new type of high resolution magnetic resonance imaging (MRI) equipment.

    "Scientists have been perplexed about how schizophrenia progresses and whether there are any physical changes in the brain," said Thompson, who is an assistant professor of neurology at the UCLA School of Medicine. "We were stunned to see a spreading wave of tissue loss that began in a small region of the brain. It moved across the brain like a forest fire, destroying more tissue as the disease progressed."

    Three super high-tech MRI scans, taken with equipment capable of finer imaging than older machines, were made roughly two years apart. They showed that the death of the participants' brain cells began in their right parietal lobes, an area at the top and toward the back of the brain that is important for logical thinking, processing input from the senses and controlling body movements. A second scan two years later revealed that the cell loss had spread very rapidly to other parts of their brains, and a third one two years after that showed that in all 12 participants, nearly the entire brain had been engulfed.

    Patients with the worst brain-cell loss also had the worst symptoms -- hallucinations, delusions, bizarre and psychotic thoughts, hearing voices, and depression. "The identification of previously unknown waves of loss and key anatomical changes will enable scientists to establish powerful links between cognitive and behavioral changes and rapid changes in underlying brain structures," Thompson said.

    About 1 percent of the population of the United States is schizophrenic; that's about 2-million 81- thousand people. Many, with medication and therapy, lead nearly normal lives, but many others spend their lives in and out of hospitals and halfway houses.

    What do the UCLA discoveries mean? With scientific caution, Thompson notes that they do not say anything about the cause or causes of schizophrenia. That remains a mystery, although there are clues.

    For one thing, schizophrenia seems to run in families. However, studies of identical twins find that one may develop the disease while his or her genetically identical twin does not. Researchers suspect that environmental factors, perhaps an infection, may trigger the disease in one twin. A study in Finland noted an increase in schizophrenia in the children of women who were pregnant during an influenza epidemic in 1957.

    Although many genes responsible for diseases have been identified, none have been found that account for schizophrenia. Thompson said it is known that some genes control the development of the brain, and it is possible some of them may be aberrant -- different in some way, or damaged.

    The disease usually appears in people in their teens and 20s. If it is inherited, why does it wait so long to show up? Thompson said he suspects there is a predisposition to developing it that only shows itself when a virus, or something in the environment, perhaps even extreme stress, sets it off.

    The schizophrenic participants of the UCLA study were between 13 and 18 years old, and all were "early onset" cases who had been diagnosed while they were still young. The rapid spread of the disease that the UCLA study revealed may not happen when older people develop schizophrenia.

    Many questions about schizophrenia still have no answers. The UCLA researchers are screening relatives of diagnosed schizophrenics, looking among other things for something that might be a predictor of whether they may develop the disease.

    Thompson is confident of one thing. The discoveries made by the UCLA group will help greatly in finding ways to diagnose schizophrenia early, and possibly in finding treatments that will stop, or at least slow, its progress. "Molecular and genetic researchers are already finding ways to affect this kind of process," he said. "That could lead to effective therapies in the future."

    The UCLA study was done in cooperation with the National Institute of Mental Health. Its findings were published in the Sept. 25 issue of the Proceedings of the National Academy of Science.


    drkoop.com
    Date Published: 10/1/01
    Date Reviewed: 10/2/01



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